Copper and Zinc Deficiency Related to Metabolic & Bariatric Surgery

Copper and Zinc Deficiency Related to Metabolic & Bariatric Surgery - Bariatric Fusion

Micronutrient deficiencies are common after metabolic and bariatric surgery (MBS). As a result, the American Society for Metabolic and Bariatric Surgery (ASMBS) has designed nutritional guidelines for MBS patients to follow.

According to the ASMBS, zinc deficiency occurs in 20-70% of metabolic and bariatric surgery patients, with a higher percentage in those who undergo malabsorptive procedures, including gastric bypass surgery (RYGB) and duodenal switch. (1)

In this article, we discuss the role of zinc in the body, what deficiency looks like, and recommendations following metabolic and bariatric surgery to support your health journey.*

The Importance of Zinc

With a varied diet, you typically consume enough zinc. However, metabolic and bariatric surgery can change that outcome due to restricted food intake and nutrient malabsorption.

The recommendations for zinc supplementation after metabolic and bariatric surgery varies based on the procedure performed. The most common range recommended by ASMBS guidelines is 8-22 mg of zinc daily.*

Zinc helps to support:*

  • Immune health*
  • Wound healing*
  • Cellular functions*
  • Protein synthesis*
  • Normal metabolism*

Sources of Zinc

Zinc is a trace element primarily absorbed in the duodenum and proximal jejunum of the small intestine. When these areas are bypassed after a surgical procedure, such as gastric bypass or duodenal switch, it can increase your risk of nutrient deficiency. For this reason, patients who have undergone metabolic and bariatric surgery require vitamin and mineral supplementation for life.*

High zinc dosages may be recommended to compensate for the loss of zinc absorption. However, high zinc intake can inhibit copper absorption and lead to copper deficiency. This is why copper is included in some bariatric supplements with high zinc levels. The ASMBS guidelines recommend the specific zinc-to-copper ratio of 1 mg copper for every 8-15 mg of zinc.*

sources of zinc

Food sources of zinc include:

  • Oysters, crab, and lobster
  • Red meat
  • Poultry
  • Beans
  • Nuts
  • Whole grains
  • Dairy products

You may consume zinc through food sources following surgery; however, a bariatric multivitamin supplement is still recommended to support adequate nutrition.*

3 Signs of Zinc Deficiency

Symptoms are not usually seen immediately; it takes time to present. It is typically diagnosed after severe depletion. For this reason and many more, it is essential to follow up with your practitioner regarding routine lab work and nutritional status.

The following symptoms may be seen with zinc deficiency:

  • Hair loss
  • Brittle nails
  • Loss of smell and taste
  • Wound healing impairment

The Importance of Copper

Copper is an essential mineral for the body. It assists iron in producing red blood cells and is a vital part of your tissues and bones.*

The incidence of copper deficiency ranges from 10-20% for individuals who have undergone roux-en-y gastric bypass. However, for those who have experienced a biliopancreatic diversion with or without a duodenal switch, the prevalence of deficiency is significantly higher at a whopping 90%. (1)

The ASMBS offers different dosage recommendations based on the metabolic and bariatric surgery performed. This dosage ranges between 1-2 mg of copper daily.*

Copper supports:*

  • Energy production*
  • Immune health*
  • Iron metabolism*
  • Neurological functions*

Sources of Copper

Copper is primarily absorbed in the proximal small intestine. Like zinc, if absorption sites are bypassed after a surgical procedure, there may be an increased need for copper.

After metabolic and bariatric surgery, recommended copper levels can be achieved through a bariatric multivitamin and dietary sources.*

Some food sources of copper include:

  • Shellfish
  • Seeds and nuts
  • Potato skins
  • Beans

sources of copper

4 Signs of Copper Deficiency

If copper is insufficient in the body, typically, one or more of the following may occur:*

  • Anemia
  • Hair loss (alopecia)
  • Diarrhea
  • Fatigue

When is Additional Copper and Zinc Supplementation Needed?*

Additional supplements should only be taken as directed by your healthcare practitioner. For most supplements, more is not always better. When taken in excess, many vitamins and minerals can cause toxic levels in the body and pose a health concern.*

A bariatric-designed zinc and copper supplement is often recommended in addition to a bariatric multivitamin when the following occurs:*

  • Lab results come back abnormal
  • You’re experiencing signs and symptoms that could be related to a nutritional deficiency
  • Inadequate dietary intake of zinc or copper
  • Inadequate nutrient supplementation
  • Preoperative malnutrition


Metabolic and bariatric surgery (MBS) can be a game-changer for healthy weight management support. Unfortunately, it also can come with a high risk of micronutrient deficiencies following surgery.

Thankfully, you can arm yourself with the right knowledge and supplementation to keep your health on track. Bariatric Fusion is here to help you reach your health goals with easy and affordable bariatric supplements.*

Are you looking for additional supplements for your bariatric regimen? We’ve got you covered!*


See also: ADEK multivitamins


  1. Surg Obes Relat Dis. 2020: 175-247

*These statements have not been evaluated by the Food & Drug Administration (FDA). These products are not intended to diagnose, treat, cure or prevent any disease.

This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your physician or another qualified health provider with any questions in regards to a medical condition. A qualified healthcare professional can best assist you in deciding whether a dietary supplement is suitable based on your individual needs.

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